Lawmakers debated last week a bipartisan push to expand postpartum Medicaid coverage for low-income Missourians from 60 days to one year — among the first public hearings of the 2023 legislative session.
The Missouri Senate’s Health and Welfare committee heard testimony on a pair of bills sponsored by Republican Sen. Elaine Gannon of De Soto and Democratic Sen. Tracy McCreery of the 24th Senate District, which includes Fenton and Sunset Hills.
The proposal was close to gaining approval from the legislature last year, but narrowly failed as collateral damage in the Republican Party’s infighting in the Senate.
“This hearing today sends a message that people are tired of differences on some issues being the excuse for inaction on every issue,” McCreery said, later adding: “It’s our hope that our partnership sends a signal about the bipartisan nature of this legislation.”
Pregnant women qualify for Medicaid during pregnancy and for 60 days thereafter, but a provision of the federal American Rescue Plan Act in 2021 allowed states to expand Medicaid coverage to 12 months.
The bill discussed Wednesday would cover the around 4,600 women per year who would otherwise lose Medicaid after 60 days postpartum, McCreery estimated.
Twenty-six states and Washington, D.C., have implemented the 12-month extension. The United States’ rate of maternal mortality exceeds those of other developed countries, and Missouri is generally in the bottom quarter — the state had the 12th highest maternal mortality rate in the country from 2018 to 2020.
There are several essentially identical bills filed so far in the House and Senate seeking to extend postpartum coverage.
Gannon said the bills have particular urgency because the continuous coverage provision of Medicaid, which has prevented the state from removing anyone from its rolls during the COVID health emergency, will end in April. That could include women who were added when pregnant but may no longer qualify, Gannon said, and could lose coverage.
The Missouri Pregnancy Associated Mortality Review Board last year found 75 percent of pregnancy-related deaths were preventable, and the greatest proportion occurred between 43 days and one year after pregnancy.
“Extending coverage to these women is so important because some of the conditions do not always present themselves in the first 60 days postpartum,” Gannon said, “They may take several months to appear.”
Women on Medicaid in Missouri are eight times more likely to die within one year of pregnancy than their counterparts with private health insurance, a multi-year report analyzing maternal mortality in Missouri published in August found.
The report also found Black women in Missouri were three times more likely to die within a year of pregnancy than white
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